Information Bulletin 00-30
Cooperative Activities With State Survey Agencies and Peer Review Organizations to Improve Quality of Care for ESRD Patients
In a recent Medicare ESRD Network Organizations Manual update, the Networks were advised that they should work with the appropriate HCFA Regional Offices, State survey agencies and Peer Review Organizations (PROs) in areas that will assist each organization to improve the quality of care for ESRD patients.
If you have any questions related to this Information Bulletin, please contact:
Minnesota Department of Health
Health Regulation Division
Licensing and Certification Program
85 East Seventh Place, Suite 300
St. Paul, Minnesota 55164-0900
Tele: (651) 201-4101
HEALTH CARE FINANCING ADMINISTRATION
Chicago Regional Office, Midwest Consortium
Electronic Regional Program letter #2000-18
DATE: June 23, 2000
FROM: HCFA, Chicago Regional Office, Division of Survey and Certification
SUBJECT: Cooperative Activities with State Survey Agencies and Peer Review Organizations to Improve the Quality of Care for ESRD Patients.
TO: State Survey Agency Directors
In a recent Medicare ESRD Network Organizations Manual update, the Networks were advised that they should work with the appropriate HCFA RO(s), State survey agency(ies) and Peer Review Organization(s) (PROs) in areas that will assist each organization to improve the quality of care for ESRD patients. These activities should include, but are not limited to, the following:
- Sharing information to assist the State survey agencies and/or PROs in carrying out their legislative responsibilities (i.e., sharing facility/patient specific information so surveys and quality improvement activities can be targeted to those needing additional interventions); and
- Referring quality of care issues, as appropriate, and assisting the State survey agency or PRO in the
investigation of the quality of care issues upon request, which may include:
Conducting reviews cooperatively (e.g., off site visits, parallel reviews, or sequential reviews, as needed);
Providing technical assistance
Providing information regarding expected outcomes; and/or
Reporting patterns of complaints or grievances.
- Coordinating and collaborating with the State survey agency in regards to QI interventions when a provider is non-cooperative or unable to implement and maintain improvements, whether in compliance with the conditions for coverage or in the provision of care, that is consistent with current professional knowledge.
Some suggestions for other activities include the following:
- Sharing data/information such as the Clinical Performance Measures Reports, standardized mortality ratios, standardized hospitalization ratios, ESRD complaints/grievances and other educational type materials;
- Collaborating in quality improvement projects;
- Providing technical assistance or training on dialysis-related patient care issues;
- Assisting State survey agencies in focusing survey resources; and
- Assisting State surveyors in understanding how to interpret and utilize Network, HCFA, and/or ESRD data.
If you have any questions about this, please contact me.
Survey and Certification Program
Coordination and Improvement